Outcome of surgically treated octogenarians with breast cancer

Breast cancer is the commonest cancer in women worldwide and its incidence increases with increasing age. In an era of evidence-based practice, there is a paucity of evidence relating to the management of breast cancer in an oncogeriatric population. The authors define oncogeriatrics as cancer in patients aged 80 years or more.

The study aimed to evaluate the survival benefit of surgically managed octogenarians with breast cancer.

This was a retrospective study of octogenarians diagnosed with breast cancer over a 5-year period and who were treated surgically. Kaplan-Meier survival analysis was used to determine the overall survival. The differences in survival were tested using the logrank (Mantel-Cox) test. A P-value of <0.05 was considered to be statistically significant.

One hundred patients were included (median age- 84 years, median follow up 3.3 years). A validated adult comorbidity evaluation-27 (ACE-27) index score system was used to characterize patient comorbidities. Fourteen percent of patients had severe comorbidities, 55% nonsevere, 11% no comorbidities, and 20% with unknown comorbidities. The estrogen receptor was positive in 67% of tumors. Eighty-four percent had mastectomy and 15% had wide local excision. Sixty-eight percent had axillary lymph node dissection, 10% had sentinel lymph node biopsy, and 5% had no axillary surgery. The majority (72%) of the tumors were pathologically T1 or T2 tumor. The Nottingham Prognostic Index (NPI) mean score was 4.4. The Kaplan-Meier survival analysis showed a median survival of 5 years. Forty-eight percent died during the observation period, with 54.2% of this group dying of causes unrelated to breast cancer.

The surgically treated octogenarians in our sample had an acceptable survival outcome.